Wednesday, February 10, 2010

Asian American Health Blog Moved!

Hello Everyone!

First we would like to thank everyone who has been following us on this blog. We also want to thank you all those who have submitted, commented or gave us input to the blog.

We are happy to announce that we are moving to a new blog site for Asian American Health! Please continue to support our work and contribute to this blog. Your thoughts and opinions are greatly appreciated!

If you would like to write or continue to write for us please email us at asianamericanhealth@gmail.com.


Best wishes,

Asian American Health Team
asianamericanhealth.wordpress.com

Friday, January 8, 2010

H1N1 Shot

Many people have been trying for weeks to get their H1N1 vaccine. In fact, my boyfriend stood in line on two different occasions at the local clinic cutting it close to being late to work and after returning from work - that's four times - and he still has not even seen the inside of the building. Queues of moms, their children, and their neighbors children are easily seen in line hours before the doors open and hours afterward, but a few weeks before Christmas I got really lucky. Alameda County held H1N1 pandemic clinics in five or six locations and my landlord/aunt got a call saying there was no line at the Rainbow Recreation Center (International Blvd. @ 58th) location! So, despite the bad weather, she asked me and we jumped in the car to get our coveted shots. I don't think I was ever as excited to get a shot. It didn't even prickle.

We circumnavigated the center to get to the hidden entrance where there was a line of 0 people. There were some people there, volunteers manning the door, the nurses, and EMTs, but there were surprisingly few people there to get the shot. Granted I got there after noon and the clinic was suppose to close at one or when they ran out, there were still very few people getting the vaccine. (!!) It was a relief from a vaccine-needing person's perspective, but it really troubled me when I got home. Where were all the people who should have and could have gotten the vaccine? Frankly, it's very troubling.

It's also very troubling that the Alameda County's Public Health Department has flyers in English and Spanish, but none in Simplified or Traditional Chinese. I do not know exactly how many Chinese-reading people live in Alameda County, but it's got to be significant since AC Transit posts its information in English, Chinese, and Spanish. According to the US Census Bureau, 24.9% of the county is Asian. 1 out of 4. Does this indicate a negligent act of information asymmetry on AC PHD's part? There is a lot of work to be done to ameliorate Asian American Health.

For your reference:
White 56.4%
Black 13.5%
Hispanic 21.8%

Saturday, November 14, 2009

Health Innovation Dreams

The creation of many new nanotechnology applications brings great advances to science. As a woman suffering with the worst teeth in the world, I have dreams of what a perfect world and wallet I would have if teeth coats were invented. Literally, little nanoparticles would coat your enamel in a way such that your teeth would be healthy, shining, and impermeable to cavities.

Nothing can be perfect and the product has to generate money regularly, so it would probably have to be something that requires reapplication every year or two. But that's a small flaw for a lot of perfect teeth. On a deeper level, another much more serious concern would be the public health safety concerns surrounding such technology. What are the potential health hazards of practical nanotechnology? If bad, are they really practical?

Currently there are very many nanoscale technologies that we use in our everyday lives such as Teflon, Gore-Tex, and carbon fiber to name a few. Those non-stick pans that are friends of the fried egg can be dangerous when more than medium heat is used as the heat burns the Teflon and lets off harmful fumes. Other surfactants like Gore-Tex can be found on your waterproof jacket. Carbon fiber, that expensive race car's hood and/or entire body.

So with the prevalence of such technologies, we have to wonder if they are safe in the long-term and worth using. If safe, great. If not, why isn't there more regulation and oversight of these products? is another question to consider. In the UK, DEFRA essentially did away with their nanotechnology oversight and the only US city looking at these technologies through regulation is Berkeley. What thoughts are out there? Will these innovations, possibly into health, only be a dream?

Friday, October 30, 2009

Opportunity Cost- What it looks like

Many of us have learned what opportunity cost is in our economics class-- it is what we give up in order to get something else. Even though I know that opportunity cost could apply to small or large-scale situations, I tend to get caught up with the small-scale. For instance, this morning I woke up half-an-hour earlier so that I could eat breakfast and the opportunity cost of that was half-an-hour of sleep. For some reason when I think about opportunity cost, my mind immediately goes to my personal day-to-day utilization of time and money.

I went into work today and my supervisor told me to research the costs of the Iraq and Afghan wars and subsequently find what the US could have spent the same amount of money on. Essentially-- opportunity cost. This is what I found from http://www.nationalpriorities.org/tradeoffs


Taxpayers in the United States will pay $915.1 billion for total Iraq and Afghanistan war spending since 2001. For the same amount of money, the following could have been provided:
  • 269,705,508 People with Health Care for One Year OR
  • 947,364,311 Homes with Renewable Electricity for One Year OR
  • 19,764,579 Public Safety Officers for One year OR
  • 15,693,033 Music and Arts Teachers for One Year OR
  • 141,481,138 Scholarships for University Students for One Year OR
  • 171,046,729 Students receiving Pell Grants of $5350 OR
  • 7,118,476 Affordable Housing Units OR
  • 403,332,085 Children with Health Care for One Year OR
  • 125,579,800 Head Start Places for Children for One Year OR
  • 15,032,444 Elementary School Teachers for One Year OR
  • 13,221,600 Port Container Inspectors for One year
In 2001, I was in seventh grade and had no idea what was happening in Iraq and Afghanistan-- it was almost a mental tune-out whenever I heard the names of these two countries. Now, being a college student, I'm experiencing over a 30% rise in tuition costs in one year with fewer instruction days and fewer scholarship opportunities. Recent graduates across all college campuses are having trouble finding employment, which is often coupled with a lack of adequate health insurance. These numbers clearly illustrate the ways in which the Iraq and Afghanistan wars have cut a plethora of resources domestically whether it be jobs, education, healthcare, etc. This is definitely not what I originally had in mind when I thought about opportunity cost.

Thursday, September 24, 2009

A Need for Change: Insights From a Patient

I am a young cancer patient, who has been afforded an unparalleled opportunity to gain insight into a flawed healthcare delivery system. I hope to share observations and opinions I have formed over my many months of treatment.

Once a month, I visit my oncologist's office to check on the status of my illness and to make changes to my treatment regimen, as needed. With 3-4 decades to spare, I am always the youngest patient at the clinic
. With a few outdated magazines and week old newspapers in the waiting room, I often am more amused by patients walking in and out rather than the provided "entertainment." It didn't take too long to notice a startling trend amongst the other patients. While my visits often ran around 30 minutes in length, other patients were ushered in and out as if they were whirling around a revolving door. At first I didn't think too much about it. I figured these patients had probably been longterm patients and the checkups became efficient and mundane for them. After a few months of visits and becoming what I would consider a longterm patient, my visits still lasted around half an hour...

In the dimly-lit and bare-walled waiting area, I began to theorize about my interesting observation. Was my situation so dire that I required extra long visits? Did the physician enjoy chatting me up compared to his other patients? Did the schedule just happen to dictate more free time around my visits?

Then IT hit me. The clinic has a strict rule against allowing patients to bring their families into the room, unless physical incapacities necessitate it. In addition, most of the older patients speak minimal to no English, as they bared with the physician's inadequate Chinese speaking skills. I, on the other hand, speak fluent English and have a solid background in science. While other patients fail to grasp what the physician is saying, not to mention their inability to understand the scientific concepts behind their illness and therapies, I always prepare a list of questions and studied my illness and therapeutic regimen carefully. Because other patients had a weak understanding of what the physician had to say, I can imagine many of them resigning to sitting quietly, waiting for the physician to conclude the visit. Not only is this an alarming trend, it is also a dangerous one. Many chemotherapy medications have strict schedules and narrow therapeutic ranges. One misstep can absolutely be fatal. In addition, these patients are not receiving the quality of care they deserve in battling such a grim illness. Understanding of the illness and therapies is unquestionably critical to a successful recovery.

This observtion has further validated my rallying call for more culturally-competent, multi-lingual health professionals. Above actual treatment, communication is key to successful healthcare delivery and successful patient recovery. While many of us strive to improve healthcare, we must not lose sight of simple things. We must be vigilant of a patient's right to know, which may necessitate the services of an interpreter. There remains a glaring need for better communication in the healthcare system. We must always remember this.

Thursday, August 27, 2009

Reflections of a Bilingual Labor Coach

||STORY||

On Saturday morning at 6:50AM I was jolted from my dreamless slumber by a loud phone call from my co-labor coach. Our patient had called her at 4AM and said she was going into labor.

I am a volunteer labor coach through Asian Health Services in Oakland, CA. Most patients are new immigrants from China who only speak Cantonese, so I help them through the labor process by interpreting what the doctors say to her, teaching her breathing and pushing techniques, and act as her emotional and physical support during the labor.

YES. MY FIRST LIVE DELIVERY. EVER. It was truly epic. EPIC! I picked up my co-coach from the bart and we rushed to Highland Hospital in Oakland, where the patient was already having contractions every eight minutes.

I proceeded to introduce myself, and told her that I was the interpreter from Asian Health. I tried to make small talk with her so she could focus her pain on something else, and chatted lightly about what the baby’s name was going to be, about the color of the baby’s room, of the chicken-ginger soup her mother-in-law was cooking for her. The doctors rushed in and out of the room, anxious to see how dilated her cervix was. The nurse who stood by me asked me to translate for her and asked for me to reposition her body and to console her through the wrenching contractions. Her husband stood by nervously, eager to understand what was going on in the blur of English sentences and half a dozen of medical staff coming in and out of the room.

I stayed by her hour after hour, wiped the sweat off her forehead. When the contractions became more frequent, grabbed her hand, and told her to concentrate. I told her in Cantonese that she was doing great—that if she could conserve all her energy and push as hard as she could, the baby would be out.

And to make a long story short........ Yes, I saw a real live vaginal delivery. The patient was in labor for four long hours. Yes, there was a boatload of blood, gore, pus, vaginal fluid, pee (they deflated her bladder using a catheter!), poop (the baby pooped), hair, amniotic fluid (water broke), genitalia, umbilical cord, a gigantic and fleshy placenta..... and more. She didn't use an epidural or any other pain medication.. she just ... toughed it out.

To anyone who doubts the pain and agony that a woman goes through labor and delivery.. ask any mother or have one of your own. I offered my hand for her to squeeze quite a few times during her contractions. I could barely feel my fingers afterwards.

What blows my mind is how strong and persevering the mother was. She just overcame the pain and worked so incredibly hard to push out her beautiful baby boy, and really, when I saw the head of the baby come out, I nearly cried from joy and relief and just pride for what she had done. It was beautiful….Absolutely surreal.

The baby boy's name is Eric. He came out healthy but what delayed his delivery was he had trouble getting out since his hand was reaching upwards and the umbilical cord was dangerously wrapped around his neck. After the delivery, the mom was getting stitched up (the doctor said that her vagina was "really torn up") and she asked me if I wanted to hold her newborn. I hesitated at first (I doubted my own child-rearing / child-holding abilities) but she insisted and there I was, holding this little life in my arms that was less than an hour old. I was at a total loss of words..................



||REFLECTION||
Despite the long hours and the sporadic nature of being a labor coach, I continue to volunteer because I know that these people really need me and our services. There really is no one else there for them. I can’t imagine being pregnant and checking into a hospital but not knowing the language or being able to communicate with the medical staff. Thus, to participate in such an intimate situation with a total stranger, where I see a breathing, crying baby emerge as a result of coaching makes me proud that I could help, and grateful that the delivery was a success. Through a common language and culture, I am happy that I was able to impact someone’s life.



||COMMUNITY||

If you are interested in becoming a volunteer labor coach, check out asianhealthservices.org and contact Thuy for more information. There are training sessions every several months, and AHS is always looking for interpreters who speak Cantonese, Vietnamese, Mandarin, Tagalog, Khmer, Mongolian, Lao, Korean, and other languages.

Wednesday, August 12, 2009

Do young adults care about health care?

I remember growing up having my parents take me to the dentist every 6 months and seeing the doctor every two years. I'm 24 now and haven't had that privilege since I graduated from UCLA 2.5 years ago.

I would think that a degree from UCLA and having a traditional upbringing in a Filipino household would teach me how to be more responsible in the real world. But this is a reality that many recent graduates face; not understanding health care.

Check out this article from The Sacramento Bee about what college grads face once they lose insurance...

http://bit.ly/GradsandHealthInsurance

This issue also brings another issue at hand. How much do people, educated or not, understand or care about in our current health care system?


Lately I've been following issues in the health care debate. Why isn't it affordable? What will people lose in this new health care reform? What will people benefit from this health care reform? And, most importantly, how can communities better understand what health care means to them?

In an ideal world people will talk about this. They will analyze it and they will advocate for their beliefs. Unfortunately, a good chunk of the uninsured population are in the 18-29 age range. And, a lot don’t know much about health care. If you have read the article I set a link to above, readers have left interesting comments regarding their take on young people not understanding healthcare. Some of the comments amaze me but make sense to a degree...


"Sorry, but, considering the fact that the majority of our society is overweight/obese and/or has some preventable chronic disease (due to smoking, drinking, not exercisizing, poor eating habits), I just have very little sympathy for this situation. Stop thinking that society owes you something; go out and earn for yourself. You'll actually appreciate what you have."

and

"The reason this is a story is that young people don’t use ins. The premium goes to those unhealthy people that do use the system. Sure they have the highest rate visits to the emergency room."

I get it, but who in their 20s know exactly how to take care of themselves? And how many people (of all ages) go out of their way to understand steps to (good) health care, much less health care in our economic and national crises?

As the health care debate heats up around our nation, it makes me wonder who in our nation has the most impact in changing the health care system. People like me I guess.

My thoughts…



  1. As a post grad who has a good future ahead for myself, I still grapple with understanding the health care system. (I’m still young and na├»ve. I learn best through growing pains like this.)


  2. If people my age could begin to question their status as far as health care is concerned, maybe it can further develop their understanding of what role they play in the health care system…
  3. …hence leading up to people actually advocating for a better health care system for themselves and even more, for their communities.

FYI...





Monday, August 10, 2009

Get Involved! Young Advocate Leadership Training (YALT)

I just wanted to inform folks of a great opportunity. The Children's Defense Fund (CDF) is offering a program called the Young Advocate Leadership Training (YALT) to undergraduates, recent grads, and young professionals. The purpose of the program is to help develop and strengthen the leadership and advocacy skills of young people. This year the program will be focusing on healthcare reform. Participants will be taught new tactics and strategies that can be implemented in their communities and on their college campuses.

This would be a great way for Asian American and Native Hawaiian Pacific Islander youth to engage in discussions about health care reform 2009 and health issues affecting them and their communities.

The CDF is accepting application for their fall YALT program Oct.2-4.

If you are interested please check out their website:

http://www.childrensdefense.org/helping-americas-children/youth-development-leadership-training/young-advocate-leadership-training-yalt-program.html

Saturday, July 18, 2009

HIV & Feminism in Vietnam

My teacher and I went in a hospital to talk to HIV patients. We talked to one. (On a side note, it was SO ODD to me that no one checked us in and we just freely walked in and picked a bed and random patient to talk to and even weirder that he was willing to answer our questions and share about his personal history. I guess one of the differences between US and Vietnamese culture.) He contracted HIV from "relations" which I assume to mean an extramarital affair or he hooked up with a prostitute.

His wife was with him and she didn't even wanna get checked! I told her she should really get checked. If I were her, I'd definitely be PISSED...one, because she might have HIV now and two, because he cheated on her and in the end, who is taking care of him? her. I guess I'm especially irritated because it seems like such a NORM for Vietnamese men to do...extramarital affairs or prostitutes (variations of...massage, at a bar, at a cafe shop, comes with beer, on the street)...a sign of manhood. And women in Vietnam are expected to take it like their grandmothers, their mothers, their sisters, and their neighbors...they all take it. Vietnamese women are PRAISED for their sacrifices...for the crap they have to put up with. Just in Malaysia, a Vietnamese women who was in Malaysia to work told me about how her husband would beat her several times a day and she still stayed for the kids. Finally it seemed like he was trying to kill her and with advice from her daughter, she finally left.

I asked him how he knew to get checked. He had a fever that wouldn't go away and then he went into the hospital and got several scans that seemed ok and finally they checked his blood. This particular hospital in Saigon (or this particular building) is for HIV patients when they turn bad...like their health is taking a turn for the worse. Otherwise, they should just be taking their medicine regularly outside of the hospital. I was most curious about prevention. Did he know how to protect himself? He said no, and he also said he didn't think enough...I'm not sure what that answer means. I asked him about sex education in school...he didn't go to school. He worked in the rural areas, and a lot of poor children or children in rural areas stop going to school. What I did read about sex education in VN though is that it's very biologically based and hard to understand. I also asked him now that he knows he is infected, has anyone told him what to do to protect others. He said nope, they just give him medicine a couple times a day. That's terrible. That information is CRUCIAL!

I was talking to one of my other teachers...his wife is part of an organization that counsels HIV patients...I am planning to call to see how I can help. Health education is SO SO important and part of this situation breaks my heart because that knowledge is a privilege that I often take for granted as a Public Health major but important knowledge that they didn't have.

Medical system in VN

I've made an active effort to learn more about the medical system here.

My doctor friend took me on a tour of the hospital and answered my questions (when I volunteered to teach English in SF, one of my students turned out to be a doctor in Saigon...crazy where connections can take you).

So I always think the doctors in America don't give each patient enough time. Vietnamese doctors are seeing about 20 patients an hour. I was like....what the???! How is that possible unless they walk in and out the door. Also, each hospital has another floor for people who are willing to pay more...the floor isn't amazing. There's still a bunch of beds in one room and all the patients can see each other..and those are the good rooms. They said that if they had money, they would also have curtains like in America. The emergency room is just a big room with a bunch of beds and sick or injured people laying on it waiting to be seen or pushed into the appropriate department.

Health insurance is given only to the selected few...health care providers automatically have it. Right now health care insurance in Vietnam is all public, but according to the doctor I talked to, only 30% of the population have it...it's really hard to get it, even if you have money. Furthermore, right now they are trying to switch to universal health care insurance.

Abortion is legal here and seems to be done pretty frequently...for younger girls (under 18), they need parental consent...but not really. Money solves all, and it's such a taboo here that the doctor will just do it anyway rather than make the girl deal with family reputation and such being lost. One of my Vietnamese friends (a few years older than me) says a lot of her friends have gotten pregnant and gotten abortions already.

That's pretty much all I know for now.